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Misophonia symptoms do not necessarily follow a strict pattern.

Sufferers experience a mixed-range of misophonia symptoms and triggers and are often faced with varying degrees of discomfort. If you believe you may have the disorder you can use this check-list.

The following are common characteristics that have been reported by misophonia sufferers. Currently there are not enough studies and not enough diagnostic criteria to have a medically-vetted comprehensive list of symptoms.

“Triggers” are usually sounds, but can also be visuals. Most of the symptoms involve an aversion to sound and visuals. These usually lead to a fight/flight response and an aversive reaction. While there is no official treatment for misophonia, you can find advice for coping and updated treatment intel here.

When looking for a cure for misophonia it is important to understand that diagnosis may not be easy to obtain. However, you can contact a professional to discuss a possible diagnosis for misophonia. This may not be “official” as the disorder does not yet have diagnostic criteria, but an understanding professional can work with you to help find a solution. Dr. Linda Girgis, an MD, hopes that misophonia patients will discuss their options with their doctor, even if they are worried about stigma.

If you believe you have misophonia, you can look below for the common misophonia signs and symptoms. Please note that since there is no official classification for misophonia, much of this is based on anecdotal evidence or small-scale studies.

Aversion to sights/sounds

Persons with misophonia are distinguished from other disorders because they are overly responsive to sounds, and secondly, visuals. (you can find a list of common misophonia triggers here). Whistling, chewing, tapping, leg swaying, clicking, and even improper spelling (such as text-speak) can also be noxious.

Heightened anxiety due to fight/flight

Persons with misophonia can become anxious awaiting triggers. Dr. Stephen Porges suggests in his podcast that misophonia sufferers are unlikely to “calm down” simply because triggers are no longer present. Like a switch stuck on, misophonia sufferers live in a constant state of fear, then fight/flight.

Withdrawal from family/friends

Since misophonia has been associated with persons closest to the individual (with family and friends being present more than other individuals), misophonia sufferers may withdraw from family events. Triggers can be traumatizing, and it can make relationships harder to maintain.

Migraines

While there is no solid proof as of yet, many with misophonia have reported migraines. This requires thorough research and the IMRN would love to study this further, if funding becomes available in the future.

Lethargy

Like migraines, there is no proof yet other than anecdotal evidence, but many with misophonia feel sick and lethargic. Dr. Stephen Porges discusses the “sickness” we feel in his podcast.

Heightened Senses

There has been research on Sensory Processing Disorder for decades. Persons with misophonia share an overlap of symptoms with SPD, though persons with misophonia suffer heavily from Sensory Over-responsivity, which is a sub-set of the disorder. These heightened senses can include:

Trouble with touch (different fabrics and surfaces)

“Scent allergies”. Many persons who are over-responsive become aroused (or even feel sick) when faced with noxious scents

Sensitivity to lights. Commonly lights that arouse the sensory system are unnatural lights such as fluorescent lighting

Sensitivity to hot/cold. Do you not like hot air in your face? Or cannot handle winter breezes? This may be a sign of a sensory struggle.

I am an experimental psychology Ph.D. candidate at the University of California, San Diego. I am studying Misophonia under Dr. V.S. Ramachandran and music cognition (specifically absolute pitch) under Dr. Diana Deutsch. In 2011 I received my B.A. in psychology and music from the University of California, Berkeley. Additionally, I’ve been a violinist since I was 5 years old, so when I’m not conducting research I can be found performing all around southern California in orchestras, chamber groups, bands and theatrical productions.

How did you get interested in Misophonia?

Back in 2011 (my first year of graduate school), my advisor Dr. Ramachandran received an email from a member of a Misophonia support group inquiring if we could begin some research on the disorder. At the time, no one had really heard of Misophonia, so we decided to invite a few members of the support group to the lab for preliminary interviews and testing. To an extent, I could relate to some of the negative feelings experienced by these Misophonia sufferers, because nobody loves the sound of another person loudly chewing gum or clicking their pen in class. For the most part these are sounds that people consider to be annoying, and I’ll admit I was a little skeptical at first as to whether this phenomenon was an actual condition or whether these individuals were simply more vocal than others about their sound issues. However, after talking to a few individuals and understanding the toll that Misophonia had taken on the quality of their lives, I realized that the disorder was definitely worth a further look. Ultimately, it was the severity of these people’s reactions paired with a lack of experimental research that inspired us to conduct our first study.

Some of our readers are familiar with your published paper on Misophonia, but some are not. Would you mind describing your study for us and telling us about your findings?

Our paper, “Misophonia: Physiological Investigations and Case Descriptions,” consisted of two main experiments. Experiment one was a series of interviews with self-identified Misophonic individuals. Since there were no official diagnostic criteria at the time, our goal was mainly to elaborate on the symptoms and behaviors associated with the condition, in hopes of gaining a more concrete understanding of the Misophonic experience.

It was in experiment two, however, that we actually collected physiological data. Experiment two was particularly important because, until recently, the only evidence we had was subjective reports from people describing autonomic arousal to certain sounds. Therefore, the goal of experiment two was to see if Misophonics actually show a quantitatively different physiological reaction to certain sounds than non-Misophonic individuals. The experimental design was such that Misophonic and non-Misophonic individuals were asked to view and listen to a series of videos and sounds (some of which we knew they disliked and some of which we considered neutral). While listening to/viewing these, they were simultaneously hooked up to electrodes that measured their skin conductance response (SCR). This equipment is sensitive enough to detect trace amounts of sweat produced from acute emotional reactions.

In addition to collecting this physiological data, we also had participants provide subjective ratings for each clip they saw or heard (on a 0-4 scale, 0 meaning the clip caused no discomfort at all and 4 meaning the clip caused extreme discomfort and anxiety). We found that Misophonic individuals showed heightened ratings and skin conductance responses to auditory but not visual stimuli (relative to non-Misophonic individuals). Additionally, we found evidence that Misophonics find similar stimuli to be aversive and non-aversive on a subjective level. The results of experiment two largely appear to validate the severity of Misophonia beyond anecdotal descriptions, and provide the first physiological evidence in support of this.

What do you think your particular area of research might add to the larger body of Misophonia research?

I believe that our particular area of research is unique in the sense that it provides both qualitative and quantitative evidence for Misophonia. The goal of our first study was to validate the experiences of Misophonia sufferers by showing that there are indeed both psychological and physiological differences in how they process certain sounds. In our future work, we intend to build upon the findings from our first study in order to develop possible strategies or inventions that may be utilized for treatment.

Are there any ways in which you think this research might one day translate into treatment for sufferers, or is it too early to make that connection?

I certainly believe that our research may one day translate into treatment for sufferers – after all, treatment is the ultimate goal. However, as research on Misophonia is still in its infancy, we are currently focusing only on trying understand all of the ‘ins-and-outs’ and quirks of the condition. I believe that once we have a clear understanding of how certain factors can modulate the severity of the Misophonic response, we will be more equipped to devise the most effective means of treatment. Currently, our lab is just beginning a new study that (if successful) may have potential application for treatment. I will definitely keep you posted about that.

I am sure that, since your paper was published, press reporters have asked you about Misophonia. What do they usually ask you? Do you find it difficult to explain the kind of work that you do to press reporters?

Speaking with press reporters can sometimes be tricky, as they have a tendency to sensationalize your research. For the most part though, I would say that I have had positive experiences with the reporters I’ve spoken to, and have been satisfied with the way in which they have portrayed my work to the public. I tend to receive a lot of questions about treatment and cures, a topic I do not feel qualified to speak on at the moment as we simply haven’t found an end-all, standardized treatment yet. Therefore, a strategy that I actively employ when speaking to reporters is to stick strictly to the data and what we already know. If something is still speculation, it is important that it is portrayed as such and not as fact. This can sometimes be difficult when dealing with a topic like Misophonia, on which little research has been conducted, but I’ve found that it is the most effective way to avoid widespread inaccuracies.

You have told us that you are also interested in music. Would elaborate on that and how that applies to your work (and/or inspires you in any way)?

As a lifelong violinist, sounds have always been a huge part of my life. In fact, all of the research I do with both of my advisors revolves around sound, but in two very different ways. With Dr. Deutsch, I study sounds specifically in the context of music, or sounds that people generally enjoy. However, with Dr. Ramachandran I study Misophonia, which is almost the completely opposite scenario. Although I do not suffer from Misophonia, I do feel that my musical background has afforded me a unique perspective when conducting research on it, as I am well aware of the ways in which sounds can evoke profound emotions in people.

If you could set up a lab with a team of cross-disciplinary researchers to study Misophonia, from which disciplines would you choose these individuals (neuroscience, audiology, etc.)?

I think it would be extremely beneficial to have neuroscientists and audiologists, as well as clinical psychologists, psychiatrists, and physicians, all collaborating together to conduct Misophonia research. Right now, a major problem for Misophonia research that needs to be addressed is the lack of communication between various fields of study. Researchers from different disciplines all have unique and valuable perspectives on the topic, but this information is not being communicated in an effective manner across groups. I believe that an interdisciplinary research environment, while simultaneously promoting a more unified dissemination of knowledge, will be the most effective at fostering breakthroughs in the field.

Jennifer:Can you just tell us a little bit about yourself, and how you got interested in research in general?

Mercede:As long as I can remember, I have been pretty curious and energetic. When I was younger this curiosity manifested in the form of destroying things in order to understand how they worked. This ongoing sense of discovery in me eventually led me to do research. Research can feed my soul and satisfy my sense of discovery.

Eventually I wanted to know why, and people may behave in different situations. This yearning for knowledge led me to the field of psychology. I studied clinical psychology for my bachelor’s and master’s degrees, taking intensive courses in affective neuroscience in Maastricht University. This helped me to specify my area of expertise to mood, anxiety and OC related disorders.

Jennifer: How did you get interested in Misophonia?

Mercede: I was doing a study titled ”Synesthesia in bipolar and schizophrenic patients: a comparative study of their relationship with abstract thinking” in 2013. This opened the door to misophonia, as misophonia and synesthesia could be similar from a neuroscientific standpoint. In short, one way to define synesthesia is provoking one sense by another, like, hearing colors or seeing sounds( Chromesthesia ). Misophonia could be almost the same phenomena, which could be: “ provoking an emotion by a sound or scene or even a touch.

Jennifer: Would you mind describing your study for us? What was your most important finding?

Mercede: While there is still no agreed set of criteria for misophonia and the research is in its infancy, we tried to clarify the very particular criteria for misophonia. Some researchers believe misophonia should be subsumed as “ decreased sound tolerance” while other researchers assume it should be classified under OC related disorders.

In this study, we introduce a wide range of emotional and physical characteristics, and thoughts, as well as an elaborate list of auditory, visual, and tactile triggers, nature of triggers, age of onset, family history, comorbidity with other disorders and phenomena, and severity, to try and get a wider, more exact inventory of the characteristics of Misophonia.

Jennifer: What do you think your particular area of research might add the larger body of misophonia research?

Mercede: My area of research would suggest a number of diagnosis
techniques and treatments for misophonia, although it is highly recommended to study misophonia thoroughly to find out different risk factors, epidemiology and etiology that are still ambiguous. I believe it is essential to do more research in order to fully understand the nature of misophonia before jumping to propose treatment.

Jennifer: If you could set up a lab with a team of cross-disciplinary researchers to study misophonia from which disciplines would these individuals be (e.g. neuroscience, audiology, etc.?)

Mercede: In my opinion, the most efficient multi-disciplinary team of research would consist of general practitioners, psychologists, psychiatrists, neuroscientists, audiologists and audiometrists. A general practitioner would evaluate the physical symptoms of misophonia and differentiate them from other similar physical manifestations. A Psychologist or psychiatrist could study the behavior and mental process of Misophonics as well as their affective and thought related aspects of disorder and copy strategies.

A neuroscientist would identify any brain dysfunction in Misophonics and possible connection of misophonia with other affective and cognitive phenomena. An audiologist could diagnose and monitor the vestibular system of the ear or the presence of other auditory problems and the possible damage to auditory system and cortex. An audiometrist, would administer audiometrist tests to enable the rehabilitation of hearing loss and differentiate Misophonics from other “decreased sound tolerance

So many people refer to misophonia as a disorder in which people aversively respond to chewing and breathing. There has been a culture that has conformed to the idea of “chewing rage”, unfortunately this does not tell the entire story. While there seems to be a high incidence of severe reactivity to chewing and other body noises it is important to keep in mind that misophonia also includes responsivity to other kinds of noises. In time research will reveal the mystery behind the noises that bother us. However, in the meantime it is always good to have on hand a short review of what the studies show us this far.

What are the symptoms of misophonia?

Individuals with misophonia are set off, or “triggered” by repetitive, patterned-based sounds, such as chewing, coughing, pencil tapping, sneezing, etc. Some individuals with misophonia also describe visual triggers.

Are the sounds always related to chewing or “people noises”?

Often people assume these are noises that from other peoples’ bodies (such as chewing). However, we really don’t know what features of the noises are causing the aversive responding. For example, it may be the repetition of the noise that is not processed properly within the auditory/neurological system, not the fact that “my friends chewing bothers me”.

Is misophonia neurological or psychiatric?

Misophonia appears to be a neurologically based disorder in which certain auditory stimuli are misinterpreted as dangerous or otherwise harmful. This atypical auditory processing may leads a fight/flight response, which leads to emotional reactivity and psychological problems.

Is there a cure for misophonia?

Not yet but research looks promising.

What different treatments or therapies are there? What therapies may exist the near future?

Right now, we know more about wasn’t doesn’t work than what does. Until we figure out the underlying neural mechanisms it is difficult to say what will help treat the condition. Psychological counseling may be helpful and earplugs that mask noise fitted by audiologists may help with daily life functioning. However, there is not an approved therapy at this time.

What do I do if I need help?

Try to find psychologists, counselors and audiologists through reliable sources such as medical doctors who have written articles on misophonia. As you sift through the many different press articles and support groups, etc. on the Internet make sure that you are corresponding with professionals who understand the disorder, who are connected to a university where misophonia is being studied, or who have been providing clinical services for misophonia or related disorders and/or who are willing to work under the direction of someone who can guide them. Most of all, go with your instinct when looking for help. If you feel that someone is treating you with disrespect or exploiting your suffering for purposes of profit, listen to your instincts.

As a mother, what was it like discovering your son has Misophonia?

Truthfully, it was both joyful and devastating if that makes sense. The joy was that we finally found out we were not alone and that this was an actual condition. Shortly after the joy, came the pain. The pain of knowing this was, in the eyes of the medical community, an obscure condition. Little was known, few recognized it and the prognosis was not good with few treatments available and chances of success with them fairly low. Every parent wants their child to be successful and happy and I think you go through a grieving period when you find out that this is going to be far more difficult than you ever imagined for them.

Has it been hard to adjust?

It’s like both your entire lives revolve around misophonia. It’s constant accommodating and as a parent, who is the main trigger, you are constantly walking on eggshells and he, as a child who loves you so much, is ridden with guilt.

How far do you go to accommodate your son?

There are many accommodations. The one thing I know and am cognizant of is that he doesn’t want to be this way and we’ve learned despite people telling me otherwise, that being tough and exposing someone to triggers does not work and is truly a horrifying experience. We eat separately, we only go to restaurants if he is in a particularly good frame of mind and feels he can cope with it and he still sits at a different table by himself or with a friend. I’ve moved his bedroom from one side of the house to another in order to give him some peace in the summer because people are active outside in their pools and hot tubs. We have lots of headphones. I attempt not to yawn ever in front of him or cough if at all possible. I pin my bangs out of my face when he’s with me because a visual trigger is me moving my hair out of my face. For appointments and trips longer than twenty minutes I have my dad or a friend drive him. I do my transcription late at night after he’s in bed so that he doesn’t hear the keyboard clicking. I do not take calls at night so he doesn’t have to hear my voice. I try not to have guests over because the conversations, laughing and other noises will trigger him. He has tv to sleep at night because it drowns out the noise. I don’t wear heels around him.

What advice would you give other parents who are discovering that their children have issues with sensory processing?

I think firstly, be supportive and not angry. Don’t take it personally. It is easier said than done when you are being yelled at for coughing or sniffling but honestly if the child could turn this disorder off they would and it’s very painful for them as well so be supportive. Try to accommodate but also make sure that you continually keep the conversation open about coping mechanisms. It’s vital that you both try to compromise and work towards a more peaceful way of living. The other advice I would give is to communicate with your friends and families so that they can also have an understanding and will try to accommodate as best they can and so you have some support. Reach out to support groups and share your successes and concerns so that you are not isolated and your child isn’t either. Also, and this may seem like common sense, monitor diet and sleep routine. A good diet and lots of rest are very helpful in managing symptoms. Stress is not our friend! I would also say don’t lose hope as difficult as things may be. There will be successes and as we reach out to each other and are open about the condition, we will gain awareness and the medical community will eventually catch up.

Does your son use any coping methods?

Headphones on occasion however this has been a real struggle. His first thoughts are that others are making the sounds on purpose and that they should simply stop. We are working on that. Right now we try breathing techniques and distraction. So if he’s feeling particularly triggered he may politely leave the space or he is to do a word search or work on his Rubik’s cube to distract his mind from the sounds. Again, he’s young and we really struggle with this because he wants to be around everyone and wants everyone to stop what they are doing and it’s not always possible to do so. It’s a day to day battle and some days are better than others.

Has your son’s education suffered from the disorder?

Yes and no. Academically he does well. I’ve educated the school officials as much as possible about misophonia and they are trying to be as accommodating as possible. He gets quiet space for tests and a peace pass to leave the class briefly when he needs to. Socially it is an issue sometimes as being around other kids can be tough. He has a select group of friends who don’t trigger him or at least try not to and are understanding of his disorder. It’s a little more challenging with Declan because he also has Tourette’s with a nasty vocal tic if triggered. It’s taken us time to develop a social network of kids and even adults who understand. I would say certain subjects have suffered. His science has suffered because his science teacher doesn’t believe in accommodating. He feels that people have to get along in the real world so this is helping to make him successful. We often have “ discussions” about his lack of accommodating and feeling it is more controllable than it is. I will be glad when he has a different science teacher.

What would it mean to you, if you could have this cured?

Having a cure for misophonia would mean everything to me. It would mean a happy future for my son. It would mean we could take our life back and be close again. It’s not like we aren’t close now but the disorder has been integrated into every moment of our days and nights and it can’t help but cause fatigue and resentment. I can’t do the fun things with him all the time. We manage but I would so love to take a holiday with him. Drive long distance in the truck and go to restaurants and just do things that other families do. People don’t understand when you can’t sit at the same table to eat. They don’t understand when you can’t take a holiday together. They don’t understand that you can’t sit in a plane beside your son as much as you love him and want to. Having a cure for misophonia would mean no more walking on eggshells trying to protect your loved one. It would mean no more begging neighbors to be quiet. It would mean no more explaining to restaurant staff to not make a big deal but sit your child at his own table. No more weird looks. Most of all, my son and I could be best friends again. It’s not like we aren’t. I think miso has drawn us closer in other ways because although I’m the main trigger, I’m also the one who understands but it’s far from perfect. I would love for us to both live life and not have to live around it.